CMS Formulary

Displaying 59821-59830 of 1611142 results.
ID: 59821
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1537209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59822
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1487086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59823
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1539953
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59824
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1539955
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59825
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1605086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59826
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 904419
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 59827
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 866436
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59828
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 855633
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59829
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607784
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 59830
Formulary ID: 00021021
Formulary Version: 14
Contract Year: 2021
RXCUI: 199245
NDC:
Tier Level: 6
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30